Elbow prosthesis

ABSTRACT

An elbow prosthesis can include a humeral component having a yoke, an ulnar component having a head, a humeral bearing positionable in a base of the humeral component, an ulnar bearing assembly configured to engage with the head, and a pin extendable through the bearing assembly and the head. The pin can be extendable into first and second ears of the yoke to enable pivotable movement of the ulnar component relative to the humeral component. The elbow prosthesis can include a first fastener insertable through the first ear of the yoke and configured to engage with the pin, and a second fastener insertable through the second ear of the yoke and configured to engage with the pin.

CROSS-REFERENCE TO RELATED APPLICATION(S)

This application is a continuation of U.S. patent application Ser. No.14/559,121, filed on Dec. 3, 2014, which is a continuation of U.S.patent application Ser. No. 13/800,567, filed on Mar. 13, 2013, nowissued as U.S. Pat. No. 8,936,647, which claims the benefit of priorityunder 35 U.S.C. § 119(e) of U.S. Provisional Patent Application Ser. No.61/663,452, filed on Jun. 22, 2012, all of which are herein incorporatedby reference in their entirety.

This application is related to U.S. application Ser. No. 13/800,650,filed on Mar. 13, 2013, entitled “ASSEMBLY TOOL FOR A PROSTHESIS.”

TECHNICAL FIELD

The present patent application relates to an orthopedic prosthesis and,more particularly, to an apparatus and methods for an elbow prosthesis.

BACKGROUND

A joint arthroplasty procedure may be performed to repair or replacedamaged bone of a patient's joint, such as bone that is damaged due to atraumatic injury or a degenerative illness. For example, during a totalelbow arthroplasty procedure, the surgeon implants a prosthetic humeralcomponent into the distal end of a patient's humerus and a prostheticulnar component into the proximal end of the patient's ulna. Theprosthetic humeral component and the prosthetic ulnar component aregenerally joined by a hinge that enables pivoting movement between theprosthetic humeral component and the prosthetic ulnar component, torecreate the natural, anatomical articulation of the elbow joint.

OVERVIEW

The present inventors recognize, among other things, an opportunity foran elbow prosthesis that allows for articulation of an ulnar componentrelative to a humeral component, while minimizing movement of thesupporting components of the elbow prosthesis, including the bearingcomponents and fasteners used to secure the components of the elbowprosthesis. The elbow prosthesis described herein can be used, forexample, in a primary total elbow arthroplasty procedure or in arevision procedure.

To better illustrate the elbow prosthesis and methods disclosed herein,the following non-limiting examples are provided:

In an example, an elbow prosthesis comprises a humeral componentcomprising a humeral stem and a yoke having first and second earsextending from a base of the yoke, a humeral bearing positionable in thebase of the yoke, an ulnar component comprising an ulnar stem and anulnar head, a first ulnar bearing positionable between the first ear ofthe yoke and the ulnar head, a second ulnar being positionable betweenthe second ear of the yoke and the ulnar head, a pin having a first endportion and a second end portion and configured to extend through theulnar head, the first ulnar bearing and the second ulnar bearing, afirst fastener insertable through at least a portion of the first ear ofthe yoke for engaging with the first end portion of the pin, and asecond fastener insertable through at least a portion of the second earof the yoke for engaging with the second end portion of the pin. Thefirst end portion of the pin can be configured to extend into the firstear of the yoke and the second end portion of the pin can be configuredto extend into the second ear of the yoke. The ulnar component can beconfigured to pivot about the pin to enable movement of the ulnarcomponent relative to the humeral component.

In an example, an elbow prosthesis comprises a humeral componentcomprising a humeral stem and a yoke having first and second earsextending from a base of the yoke, an ulnar component comprising anulnar stem and an ulnar head, an ulnar bearing assembly structured toengage the ulnar head, a pin configured to extend through the ulnar headand the bearing assembly, a first screw having a threaded headconfigured to be received within the threaded bore of the first ear, anda second screw having a threaded head configured to be received withinthe threaded bore of the second ear. Each of the first and second earsof the yoke can have a threaded bore. The pin can have a first endportion positionable within a first opening in the first ear of the yokeand a second end portion positionable within a second opening in thesecond ear of the yoke. The ulnar component can be configured to pivotabout the pin to enable movement of the ulnar component relative to thehumeral component. The first screw can include a non-threaded portionconfigured to engage with the first end portion of the pin. The secondscrew can include a non-threaded portion configured to engage with thesecond end portion of the pin.

In an example, a method of repairing an elbow joint of a patientcomprises inserting an ulnar stem of an ulnar component into an ulnarmedullary canal of the patient, assembling a bearing assembly onto anulnar head of the ulnar component, inserting a humeral stem of a humeralcomponent into a humeral medullary canal of the patient, placing a firstend portion of a pin into a first opening in a first ear of the yoke anda second end portion of the pin into a second opening in a second ear ofthe yoke, and threading a first fastener into the first ear of the yokeand a second fastener into the second ear of the yoke to secure thehumeral component to the ulnar component. The ulnar head of the ulnarcomponent can remain exposed outside of the ulnar medullary canal. Ayoke of the humeral component can remain exposed outside of the humeralmedullary canal. The ulnar component can pivot relative to the humeralcomponent. A portion of the first fastener can engage with a first endportion of the pin and a portion of the second fastener can engage witha second end portion of the pin.

This overview is intended to provide a summary of subject matter of thepresent patent application. It is not intended to provide an exclusiveor exhaustive explanation of the invention. The detailed description isincluded to provide further information about the present patentapplication.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings, which are not necessarily drawn to scale, like numeralsmay describe similar components in different views. Like numerals havingdifferent letter suffixes may represent different instances of similarcomponents. The drawings illustrate generally, by way of example, butnot by way of limitation, various embodiments discussed in the presentdocument.

FIG. 1 is a perspective view of one example of an elbow prosthesis inaccordance with the present patent application.

FIG. 2 is a perspective view of the elbow prosthesis of FIG. 1, rotatedapproximately 180 degrees.

FIG. 3 is an exploded perspective view of the elbow prosthesis of FIG.2.

FIG. 4A is a front view of a humeral component of the elbow prosthesisin accordance with the present patent application.

FIG. 4B is a side view of the humeral component of FIG. 4A.

FIG. 4C is a back view of the humeral component of FIG. 4A.

FIGS. 4D and 4E are perspective views of a yoke of the humeral componentof FIG. 4A.

FIG. 5 is a perspective view of a fastener of the elbow prosthesis inaccordance with the present patent application.

FIG. 6 is a perspective view of a pin of the elbow prosthesis inaccordance with the present patent application.

FIG. 7 is a perspective view of a humeral bearing of the elbowprosthesis in accordance with the present patent application.

FIGS. 8A and 8B are perspective views of an ulnar bearing of the elbowprosthesis in accordance with the present patent application.

FIG. 9 is a perspective view of the elbow prosthesis of FIGS. 1-3 in apartially assembled state.

FIG. 10A is a side view of a portion of the elbow prosthesis of FIG. 9in an assembled state.

FIG. 10B is a perspective view of a portion of the elbow prosthesis ofFIG. 10A with a portion of the yoke of the humeral component partiallycut-away.

FIG. 10C is a cross sectional view of a portion of the elbow prosthesisof FIG. 10A.

FIG. 10D is an end view of the portion of the elbow prosthesis of FIG.10B.

FIG. 11 is a cross-sectional view of a portion of the humeral componentand the humeral bearing of the elbow prosthesis prior to coupling thehumeral bearing to the humeral component.

FIG. 12 is a cross-sectional view showing the humeral bearing coupled tothe humeral component.

FIG. 13A is a perspective view of a portion of the elbow prosthesis inan assembled state.

FIG. 13B is a cross-sectional view of a portion of the elbow prosthesisof FIG. 13A.

FIG. 14 illustrates a method of repairing an elbow joint of a patientusing an elbow prosthesis in accordance with the present patentapplication.

DETAILED DESCRIPTION

The present application relates to devices and methods for an elbowprosthesis that can be used in an elbow arthroplasty procedure. FIG. 1shows an example of an elbow prosthesis 100 that can include a humeralcomponent 102 and an ulnar component 104. The elbow prosthesis 100, asshown in FIG. 1, is oriented anatomically (i.e. how the elbow prosthesis100 would be oriented if implanted in a body of a patient) and the ulnarcomponent 104 is at an angle of approximately forty-five (45) degrees,relative to the humeral component 102. The humeral component 102 can bepartially received within a humeral medullary canal, and the ulnarcomponent 104 can be partially received within an ulnar medullary canal.As will be described in further detail below, the elbow prosthesis 100can include a suitable connection means that can allow for pivotingmovement of the ulnar component 104 relative to the humeral component102.

FIG. 2 shows the elbow prosthesis 100 rotated approximately 180 degreesrelative to what is shown in FIG. 1. The elbow prosthesis 100 caninclude the humeral component 102, the ulnar component 104, a humeralbearing 106, a first ulnar bearing 108, a second ulnar bearing 110, afirst fastener 112, a second fastener 114, and a pin 116. Each of thesecomponents is also shown in FIG. 3, which is an exploded view of theelbow prosthesis 100 shown in FIG. 2.

With reference to FIG. 3, the humeral component 102 can include ahumeral stem 118, a flange 120, and a yoke 122 extending from thehumeral stem 118. The yoke 122 can include a first ear 124 and a secondear 126. The humeral bearing 106 can be positioned in or coupled to abase 128 of the yoke 122.

The ulnar component 104 can include an ulnar stem 130, an ulnar head 132having an aperture or opening 134 extending through the ulnar head 132,and an ulnar neck 131 between the head 132 and the stem 130. The ulnarhead 132 can also be referred to as an ulnar eye.

Each of the first 108 and second 110 ulnar bearings can extend into theaperture 134 of the ulnar head 132. The pin 116 can extend through thefirst ulnar bearing 108, the ulnar head 132, and the second ulnarbearing 110. Opposing end portions of the pin 116 can extend into thefirst 124 and second 126 ears of the yoke 122 of the humeral component102. When assembled to the humeral component 102, the pin 116 can definean axis upon which the ulnar component 104 can pivot relative to thehumeral component 102.

The first fastener 112 can extend into the first ear 124 of the yoke 122and the second fastener 114 can extend into the second ear 126 of theyoke 122 to secure the humeral 102 and ulnar 104 components to oneanother. In an example, the first 112 and second 114 fasteners can be afirst screw and a second screw, respectively. The engagement between thefirst fastener 112, the first ear 124, and the pin 116, as well as asimilar engagement between the second fastener 114, the second ear 126,and the pin 116, is described in further detail below.

When the humeral component 102 and the ulnar component 104 are implantedinto a humerus and an ulna, respectively, of a patient, the yoke 122 ofthe humeral component 102 and the ulnar head 132 of the ulnar component104 can remain exposed. The ulnar head 132 can be configured to pivotabout the pin 116 to enable movement of the ulnar component 104 relativeto the humeral component 102, as described above.

The humeral component 102 and/or the ulnar component 104 can be made ofone or more materials suitable for implantation within a human or animalbody. These materials can include, but are not limited to, stainlesssteel, titanium, cobalt, or one or more alloys thereof. In an example,the humeral component 102 can be titanium. In an example, the ulnarcomponent 104 can be titanium. The ulnar head 132 of the ulnar component104 can include a surface treatment that can improve wear resistance ofthe ulnar head 132 as it articulates against a bearing surface. Anexample of such a surface treatment can include surface nitriding asdisclosed in US Publication No. 2010/0051141.

FIGS. 4A-4E show various views of the humeral component 102. FIG. 4A isa view of an anterior side of the humeral component 102, and shows thehumeral stem 118, the flange 120, and the yoke 122 including the first124 and second 126 ears extending from the base 128 of the yoke 122. Thebase 128 can include a recess or opening 144 extending into the base128.

FIG. 4B is a view of a lateral side of the humeral component 102. Asshown in FIG. 4B, the first ear 124 of the yoke 122 can include anopening 146. In an example, the opening 146 can be a generally V-shapedopening. In some examples, the V-shaped opening 146 can be configuredfor a specific engagement with the pin 116, as described further below.In other examples, any suitable shape for the opening 146 can beutilized. The second ear 126 can include a similar opening, which isdescribed in further detail below.

FIG. 4C is a view of a posterior side of the humeral component 102. Thehumeral component 102 can include a hole or opening 148 in the base 128of the yoke 122, on the posterior side and near the stem 118. Theopening 148 can be used as an access hole for a surgical tool configuredto assist with implantation of the elbow prosthesis 100 during surgeryand/or during a post-implant surgery. The humeral component 102 caninclude a first bore 150 in the first ear 124 and a second bore 152 inthe second ear 126. In an example, the first 150 and second 152 borescan be threaded bores.

FIGS. 4D and 4E are perspective views of a portion of the humeralcomponent 102 illustrating various features of the yoke 122, includingfeatures of the first 124 and second 126 ears. FIGS. 4D and 4E generallyshow an exterior of the first ear 124 and an interior of the second ear126. In an example, the first 124 and second 126 ears are substantiallysimilar.

The second ear 126 can include an opening 154, similar to the opening146 on the first ear 124. In an example, the opening 154 can be agenerally V-shaped opening. The opening 154 can extend through thesecond ear 126 to form a generally V-shaped seat 156 in the second ear126. The opening 154 can be sized, shaped, or otherwise configured toreceive the pin 116.

As shown in FIGS. 4D and 4E, the openings 146 and 154 can extend from aninside surface to an outside surface of the ears 124 and 126,respectively. In other examples, the openings 146 and 154 do not extendthrough to the outside surfaces of the ears 124 and 126, depending, forexample, on how the openings 146 and 154 are formed during themanufacture of the humeral component 102. The openings 146 and 154 canbe formed in order to form the V-shaped seats (seat 156) inside thefirst 124 and second 126 ears. An engagement of the pin 116 in thev-shaped seat 156 is described further below.

The second ear 126 can include a recess 158 formed in an upper portionof the second ear 126. The recess 158 can include at least one surfacecontour feature 160A formed on an interior wall of the second ear 126.The feature 160A, shown in FIG. 4D, can be sized, shaped, or otherwiseconfigured to increase a distance between two inside walls forming therecess 158, such that a width between the inside walls can be more thana width of an opening defining the recess 158. This difference in widthbetween the inside walls and the opening of the recess 158 can provide apress-fit when a tab on one of the ulnar bearings (see FIGS. 8A and 8B)is inserted into the recess 158. A surface contour feature 160B is shownin FIG. 4E on an opposite wall from the feature 160A.

The second ear 126 can include a second recess 164 formed between theopening 154 and the recess 158; the second recess 164 can be sized,shaped, or otherwise configured to allow passage of one of the screws(see FIG. 5), as described further below. The second ear 126 can includea first channel 162 formed through an interior of the second ear 126.The first channel 162 can be sized, shaped, or otherwise configured toreceive an end portion of one of the fasteners and can be aligned withat least a portion of the second recess 164. In an example, the recessareas 158 and 164, and the opening 154 can form one generally continuousrecess in the second ear 126.

The yoke 122 can include a seating surface 166 in the base 128 of theyoke 122. The seating surface 166 can include the recess 144 (see FIG.4A).

A recess 167 can be formed in an upper portion of the first ear 124,similar to the recess 158 of the second ear 126. The other correspondingfeatures on the interior of the first ear 124 are generally not visiblein FIGS. 4D and 4E; in an example, these corresponding features of thefirst ear 124 can be substantially similar to those of the second ear126.

FIG. 5 is a perspective view of the second screw 114. In an example, thefirst screw 112 can be substantially similar to the second screw 114.The second screw 114 can include a threaded portion 168, a cylindrical(tapered) portion 169, a conical portion 170, and an end portion 172. Inan example, as shown in FIG. 5, the threaded portion 168 can beexternally threaded. In certain examples, the threaded portion 168 canbe internally threaded. The threaded portion 168 can have a largerdiameter than the end portion 172. The cylindrical portion 169 and theconical portion 170 can be a non-threaded portion of the screw 114. Thescrew 114 can include an internal drive feature 174 that allows for useof a tool to fasten the screw 114 to another component, such as thesecond ear 126 of the yoke 122. In certain examples, the screw 114 caninclude an external drive feature.

The first 112 and second 114 screws can be made of one or more materialssuitable for implantation within a human or animal body. These materialscan include, but are not limited to, stainless steel, titanium, cobalt,or one or more alloys thereof. In an example, the first 112 and second114 screws can be cobalt chrome.

FIG. 6 is a perspective view of the pin 116, which can include a firstend portion 176, a second end portion 178, and a main body portion 180.The first end portion 176 can include a first groove 177, a first outerdiameter 181, and a first inner diameter 183. The second end portion 178can include a second groove 179, a second outer diameter 185, and asecond inner diameter 187. As shown in FIG. 6, the main body portion 180can have a larger diameter than the inner diameters 183 and 187 and theouter diameters 181 and 185 of the first 176 and second 178 endportions.

The pin 116 can be made of one or more materials suitable forimplantation within a human or animal body and for enabling pivotingmovement of one component relative to another component. These materialscan include, but are not limited to, stainless steel, titanium, cobalt,or one or more alloys thereof. In an example, the pin 116 can be cobaltchrome.

FIG. 7 is a perspective view of the humeral bearing 106, which caninclude an articulation surface 182, a first rail 184, a second rail186, a seating surface 188, and a peg 190. The humeral bearing 106 canbe attached to the base 128 of the yoke 122 of the humeral component102, such as by inserting the peg 190 into the recess 144 in the yoke122 (see FIG. 4A). The connection between the humeral bearing 106 andthe humeral component 102 is described further below in references toFIGS. 11 and 12. The peg 190 can include a collar portion 191 and a baseportion 192.

The articulation surface 182 of the humeral bearing 106 can be sized,shaped, or otherwise configured such that the ulnar head 132 of theulnar component 104 can articulate against the articulation surface 182when the ulnar component 104 pivots relative to the humeral component102.

The humeral bearing 106 can include four ears 194; two ears 194 can belocated at the corners formed between the seating surface 188 and thefirst rail 184, and two ears 194 can be formed at the corners formedbetween the seating surface 188 and the second rail 186. The ears 194can facilitate a secure fit of the humeral bearing 106 in the base 128of the yoke 122, such as through a press fit of the ears 194 into thebase 128 of the yoke 122, and can limit movement of the humeral bearing106, for example, when forces are applied to the humeral bearing 106.

FIGS. 8A and 8B show two perspective views of the first ulnar bearing108. FIG. 8B shows the first ulnar bearing 108 rotated approximately 90degrees relative to the view shown in FIG. 8A. The first ulnar bearing108 can include an external face 196, a tab 198, a slot 199, andshoulders 200 and 202 on each side of the tab 198. The external face 196can be a seating surface between the first ulnar bearing 108 and thefirst ear 124 of the yoke 122.

The first ulnar bearing 108 can include a first opening or hole 204 forreceiving the pin 116. In an example, the first hole 204 can include achamfer 206 to help lead the pin 116 through the first hole 204.

The first ulnar bearing 108 can include a first bearing extension 208having an articulation surface 210 and an end face 212. A second openingor hole 214 can extend through the end face 212 for receiving the pin116. In an example, the second hole 214 can include a chamfer 216 tohelp lead the pin 116 through the second hole 216. A compression rib 218can extend from the end face 212 on at least a portion of the end face212. The first 204 and second 214 holes can converge within the firstulnar bearing 108 so as to form a single continuous channel that isstructured to allow passage of the pin 116.

In an example, the second ulnar bearing 110 can be substantially similarto the first ulnar bearing 108. When rotated by approximately 180degrees relative to the position in FIG. 8A, the second ulnar bearing110 can mate with the first ulnar bearing 108.

The humeral bearing 106 and/or the first 108 and second 110 ulnarbearings can be made of one or more materials suitable for implantationwithin a human or animal body. In an example, the humeral bearing 106and/or the first 108 and second ulnar bearings 110 can be made of anelastomeric material, such as, for example, a ultrahigh molecular weightpolyethylene (UHMWPE). In an example, the humeral bearing 106 can beformed from a crosslinked ultrahigh molecular weight polyethylene blendstabilized with Vitamin E, such as disclosed in U.S. Pat. No. 7,846,376.In an example, the first 108 and second 110 ulnar bearings can be formedfrom a crosslinked ultrahigh molecular weight polyethylene blendstabilized with Vitamin E. When formed from an elastomeric material, thebearings 106, 108 and 110 can be squeezed or compressed, for example toovercome an interference fit or press fit, and/or conform to asurrounding metal component.

FIG. 9 shows the elbow prosthesis 100 of FIGS. 1-3 in a partiallyassembled position. As shown in FIG. 9, a bearing assembly 230 can beassembled onto the ulnar head 132 of the ulnar component 104. Thebearing assembly 230 can include the first ulnar bearing 108, the secondulnar bearing 110, and the pin 116. The first bearing extension 208 ofthe first ulnar bearing 108 (see FIG. 8B) can extend into the aperture134 of the ulnar head 132. A second bearing extension on the secondulnar bearing 110 can extend into the aperture 134 such that when thebearing assembly 230 is assembled onto the ulnar head 132, the end face212 of the first ulnar bearing 108 (see FIG. 8B) can contact an end faceon the second ulnar bearing 110. The main body portion 180 of the pin116 (see FIG. 6) can extend through the first ulnar bearing 108, theulnar head 132, and the second ulnar bearing 110; the first end portion176 (see FIG. 6) and the second end portion 178 of the pin 116 canremain exposed at this point in the assembly of the elbow prosthesis100. When the first 108 and second 110 ulnar bearings are assembled ontothe pin 116, the end faces can contact one another; in an example, acompression of the first 108 and second 110 ulnar bearings with oneanother can occur at a later step when the bearings 108 and 110 and theulnar component 104 can be attached to the humeral component 102.

A next step in the assembly of the elbow prosthesis 100 can includeconnecting the ulnar component 104 to the humeral component 102, whichcan include placing the first end portion 176 of the pin 116 into thefirst ear 124 of the yoke 122 and placing the second end portion 178 ofthe pin 116 into the second ear 126 of the yoke 122. The pin 116 and thefirst 124 and second 126 ears of the yoke 122 are each configured suchthat the first end portion 176 of the pin 116 can be secured inside theopening 146 formed in the first ear 124 and the second end portion 178of the pin 116 can be secured inside the opening 154 formed in thesecond ear 126.

As described above, the first 108 and second 110 ulnar bearings can beformed of one or more elastomeric or compressible materials such thefirst 108 and second 110 ulnar bearings can be squeezed or compressedtogether as the bearing assembly 230 and the ulnar component 104 areassembled onto the humeral component 102. In an example, when the first108 and second 110 ulnar bearings are squeezed together, the compressionrib 218 on the first ulnar bearing 108 (see FIG. 8B) can compressagainst an end face on the second ulnar bearing 110, and a compressionrib on the second ulnar bearing 110 can compress against the end face212 on the first ulnar bearing 108 (see FIG. 8B). In an example, thecompression ribs can each be generally semi-circular such that the whenthe end faces of the first 108 and second 110 ulnar bearings are incontact, the compression ribs together form a generally circular shape.

Once the ulnar bearing assembly 230 is attached to the humeral component102, the first 108 and second 110 ulnar bearings can be secured withinthe yoke 122. In an example, the external face 196 of the first ulnarbearing 108 (see FIG. 8A) can contact an inner surface 232 of the firstear 124, and an external face 234 on the second ulnar bearing 110 cancontact an inner surface of the second ear 126. The tab 198 on the firstulnar bearing (see FIG. 8A) can be press fit into the recess 167 formedin the upper portion of the first ear 124; a tab 236 on the second ulnarbearing 110 can be press fit into the recess 158 formed in the upperportion of the second ear 126 (see FIG. 4D). In an example, the tab 198on the first ulnar bearing 108 can be compressed during insertion of thetab 198 into the recess 167, until the tab 198 is through an opening ofthe recess 167, at which point the tab 198 can relax and conform to aspace within the recess 167. As discussed above, surface contourfeatures 160A and 160B formed on the inside walls of the recesses in thefirst 124 and second 126 ears can facilitate the press-fit.

A next step in the assembly of the elbow prosthesis 100 can includeinserting the first fastener 112 through the bore 150 of the first ear124 and inserting the second fastener 114 through the bore 152 of thesecond ear 126. This is further described below in reference to FIG. 10.Once the assembly is complete, the ulnar component 104 can pivot aboutthe pin 116 such as to provide pivotal movement of the ulnar component104 relative to the humeral component 102. As the ulnar component 104moves, the ulnar head 132 can articulate against the articulationsurface 182 of the humeral bearing 106.

The assembly of the elbow prosthesis 100 can be configured such that thebearings 106, 108 and 110, or at least one feature on the bearings 106,108 and 110, can compress during an assembly of the elbow prosthesis 100and then relax and conform to a surrounding area. Various features onthe bearings, such as the tabs described above, or the ears 194 on thehumeral bearing 106, can allow an interference fit or press fit that canresult in a stable placement of the bearings in the elbow prosthesis100, such as to reduce or eliminate any movement of the bearings 106,108, and 110 within the elbow prosthesis 100, particularly as variousforces or loads are placed on the bearings 106, 108, and 110. In certainexamples, alternative or additional features to those described hereincan be used on the bearings 106, 108, 110 to provide a press fit.

FIG. 10A is a side view of a portion of the elbow prosthesis 100 asassembled, showing the second ear 126 of the humeral component 102 and aportion of the ulnar component 104, including the ulnar neck 131 and aportion of the stem 130. As shown in FIG. 10A, the second end portion178 of the pin 116 can be seated inside the opening 154 formed in thesecond ear 126. In an example, the opening 154 can be generally V-shapedand the end portion 178 of the pin 116 can have at least two points ofcontact C1 and C2 with a seat 156 formed by the opening 154. The seat156 can be sized, shaped, or configured to keep the pin 116 in a desiredposition and limit or resist movement of the pin 116. The first endportion 176 of the pin 116 can be similarly seated inside the opening146 formed in the first ear 124. The position of the pin 116 in theopening 154 is described further below in reference to FIGS. 10C and10D. The same description generally applies to the position of the pin116 in the opening 146. As described above in reference to FIGS. 4D and4E, the openings 146 and 154 may not, in some examples, extend throughto an outside of the ears 124 and 126. The openings 146 and 154 can beconfigured to create the v-shaped seats inside the ears 124 and 126 forengaging with the pin 116.

FIG. 10B is a perspective view of the assembled elbow prosthesis 100 ofFIG. 10A with a portion of the second ear 126 of the humeral component102 cut-away in order to show the various components inside andsurrounding the second ear 126. In addition to the second ear 126, FIG.10B shows the second end portion 178 of the pin 116, the screw 114, thesecond ulnar bearing 110, the ulnar head 132, the first ulnar bearing108, and the first ear 124. The second screw 114 can extend into thesecond ear 126. In an example, the second screw 114 can extend into thesecond ear 126 at an angle in the anterior-posterior direction. Thethreaded portion 168 of the screw 114 can engage with a threaded bore152 in the second ear 126. The conical or non-threaded portion 170 canengage with the second end 178 of the pin 116. The conical portion 170can engage with the groove 179 (FIG. 6) of the pin 116 between the inner187 and outer 185 diameters of the end portion 178. The end portion 172of the screw 114 can be received in the channel 162 formed in the secondear 126.

As shown in FIG. 10B and described above in reference to the tab 198,the tab 236 on the second ulnar bearing 110 can be press fit into therecess 158 of the second ear 126 to secure the second ulnar bearing 110to the second ear 126 and minimize or resist movement of the secondulnar bearing 110.

FIG. 10C is a cross-sectional view of the elbow prosthesis 100 takenalong the line 10C-10C in FIG. 10A. FIG. 10C shows an engagement betweenthe second end portion 178 of the pin 116 and the conical portion 170 ofthe second screw 114, as well as an engagement between the first endportion 176 of the pin 116 and the first screw 112. The engagementbetween the second screw 114 and the pin 116 is described in furtherdetail herein in reference to FIGS. 10C and 10D; the engagement betweenthe first screw 112 and the pin 116 can be substantially similar.Contact areas C8 and C9 shown in FIG. 10C are described below inreference to FIG. 13B.

When the elbow prosthesis 100 is implanted in an elbow of a patient, theprosthesis can undergo various anatomic forces or loads, including aninternal/external rotation force F1, a varus load F2, and a valgus loadF3. A compressive joint load, which can occur in a general directionrepresented as a vector V3 in FIG. 10C, can be one of the highest forceson the prosthesis 100 and can also be referred to as an anatomic load.The design of the screw 114 and the pin 116, and their placement in thehumeral component 102 can be configured to avoid or minimize exposure tocyclic transverse loading/unloading and/or load reversal, and tominimize or resist unloading of any of the components, in particular thescrew 114, even under the various forces and high compressive jointloading described above. As further described below, the screw 114 andthe pin 116 can be configured to minimize or resist loosening of thescrew 114 over time, as compared to other prosthesis designs in whichthe screw can become looser. A specific engagement of the screw 114 withthe pin 116 can be used to hold the pin 116 in place even under highcompressive joint loads. As described further below, the screw 114 andthe pin 116 can resist micro-motion in at least one direction.

The conical portion 170 of the screw 114 (FIG. 10B) can be received inthe groove 179 formed in the second end portion 178 of the pin 116. Inan example, the conical portion 170 of the screw 114 can have at leasttwo points of contact C3 and C4 with the pin 116, such points of contactcan generally be centered around the groove 179 in the pin 116. (A planein the center of the groove 179 is shown as PL1 in FIG. 10C.) The screw114 can serve as a wedge to hold the pin 116 within the second ear 126and minimize or resist movement of the pin 116 as the pin 116 is exposedto various forces and loads. The points of contact C3 and C4 between thepin 116 and the screw 114 can help hold down the pin 116 to minimizemovement of the pin 116 from side to side, especially when theprosthesis is exposed to the various forces described above and shown inFIG. 10C, and can help minimize or resist micro-motion in a directionindicated by M2 in FIG. 10C.

As described above in reference to FIG. 10A, the end portion of the pin178 can have at least two points of contact C1 and C2 with the seat 156.In an example, the end portion 178 of the pin 116 can have four pointsof contact with the seat 156. The contact point C1 can be on the outerdiameter 185 (FIG. 6) of the end portion 178 and another contact pointC5 can be on the inner diameter 187 (FIG. 6) of the end portion 178. Thecontact point C2 can be similarly situated to the contact point C1, andalthough not visible in FIG. 10A or 10C, another contact point similarlysituated to the contact point C5 can be on the inner diameter 187 of theend portion 178, adjacent to the contact point C2. These contact pointsof the pin 116 in the seat 156, in addition to the engagement of thescrew 114 and the pin 116, can minimize or resist micro-motion in adirection indicated by M1 in FIG. 10C.

As the screw 114 is inserted into the bore 152 (FIG. 10B), the screw 114can drive into the groove 179 in the pin 116 which can move the secondend portion 178 of the pin 116 into the seat 156 of the ear 126 of thehumeral component 102 (FIG. 10A). However, the pin 116 can move up anddown or flex in response to forces on it, including the high compressivejoint load, shown as the vector V3 in FIG. 10C. A profile P2 in FIG. 10Crepresents a profile of the pin 116 when under high compressive jointload. The pin 116 can thus flex back and forth, and as a result of theflexing action, the second end 178 of the pin 116 can move and push upon the screw 114 in a reactive load direction, represented by a vectorV2 in FIG. 10C. (A profile of the screw 114 when under a maximumreactive load can be represented as a profile P1 in FIG. 10C.) The screw114 can be tightened until the prescribed screw torque is reached, whichcan ensure that all the mating surfaces of the components are compressedtogether. As described above, the screw 114 can have various points ofcontact with the pin 116—thus the screw 114 can be supported by the pin116 while the prescribed screw torque is being reached, which can allowthe screw 114 to elastically bend away from the pin 116 as the screw 114is driven in.

Elastic bending of the screw 114 can generate a force in a directionrepresented by a vector V1 in FIG. 10C—the force is a clamping loadcreated by tightening of the screw 114. The clamping load can counteractthe reactive load created by the pin 116 (reactive load directionrepresented as the vector V2). The clamping load by the screw 114 cansecure the pin 116 against the seat 156.

As the screw 114 tightens and bends, the screw 114 can exert force onthe pin 116. Over an operational life of the prosthesis 100, there canbe wear that can cause the screw 114 to gradually rebound towards anunbent shape; however, even then, the screw 114 can continue to apply acompressive load on the pin 116 to resist micro-motion. Although theclamping load can decrease over time, a residual clamping load over thelife of the prosthesis 100 can be maintained at the various contactpoints between the pin 116 and the screw 114, and the pin 116 and theseat 156. This residual clamp load can provide long-term resistance forloosening of the screw 114 and/or the resistance for the micro-motionsmentioned above.

As also shown in FIG. 10D, FIG. 10C shows the cylindrical portion 169 ofthe screw 114 having a point of contact C6 with an inside portion of theear 126 of the humeral component 102.

FIG. 10D is an end view of the portion of the elbow prosthesis 100 shownin FIG. 10B. The profile P1 of the screw 114 under maximum reactive loadcan be seen in FIG. 10D. Moreover, FIG. 10D shows many of the contactpoints shown in FIG. 10C and described above. In addition to the contactpoint C6, the screw 114 can have at least one other point of contact C7with the inside portion of the ear 126 of the humeral component 102. Asshown in FIG. 10D, in an example, the end portion 172 of the screw 114can have a point of contact C7 with the humeral component 102. Inaddition, the pin 116 has the four points of contact with the opening154 in the ear 126, as described in reference to FIG. 10C. As statedabove, these points of contact can help to minimize unloading and/orminimize or resist micro-motion in at least the direction indicated byM1 in FIG. 10C.

FIG. 11 is a cross-sectional view of a portion of the humeral component102 and the humeral bearing 106, prior to securing or attaching thehumeral bearing 106 to the humeral component 102. Specifically, FIG. 11shows the base 128 of the yoke 122, including the seating surface 166and the recess 144, and a portion of the stem 118 and the flange 120 ofthe humeral component 102. The humeral bearing 106 can be configured toattach to the base 128 of the yoke 122. As described above in referenceto FIG. 7, the humeral bearing 106 can include the seating surface 188and the peg 190. The peg 190 can be generally circular shaped, and thecollar portion 191 of the peg 190 can have a larger diameter than a baseportion 192.

In an example, the recess 144 in the base 128 can be a generallycircular shaped recess. In certain examples, the recess 144 can have anon-circular shape and the peg 190 can have a non-circular shape.

FIG. 12 shows the humeral component 102 and the humeral bearing 106 asthe humeral bearing 106 is secured to the humeral component 102, such asby securing the peg 190 in the recess 144.

In an example, the peg 190 can be inserted into the recess 144 byapplying a force to the humeral bearing 106, such as using a blunt toolthat contacts the articulation surface 182 of the humeral bearing 106.The force can be applied until the peg 190 compresses and squeezesthrough an opening of the recess 144. Once the collar portion 191 isthrough the opening, the collar portion 191 can relax or spread outwithin the recess 144. FIG. 12 shows at least one interference I1 and I2between the collar portion 191 and the walls forming the recess 144. Thepeg 190 can overcome this generally circumferential interference, suchas by the compression of the collar portion 191 as described above. Thistype of press-fit can promote a secure attachment of the humeral bearing106 to the humeral component 102 and can limit or resist movement of thehumeral bearing 106.

At least one undercut 189 can be included in the seating surface 188 ofthe humeral component 106 such that the seating surfaces 166 and 188 ofthe base 128 of the humeral component and the humeral bearing 106,respectively, can contact one another.

FIG. 13A shows the elbow prosthesis 100 in an assembled position andincludes the humeral component 102 having the first 124 and second 126ears, and the ulnar component 104 having the ulnar head 132 shownbetween the first 108 and second 110 ulnar bearings.

FIG. 13B is a cross-sectional view of the elbow prosthesis 100 takenalong the line 13B-13B in FIG. 13A. FIG. 13B shows an engagement of theulnar head 132 with the humeral bearing 106 and an engagement of theulnar head 132 with the first ulnar bearing 108. As the ulnar head 132articulates, an outer surface of the ulnar head 132 can contact thearticulation surface 182 of the humeral bearing 106 in a contact arearepresented by C8 in FIG. 13B. Over time, surfaces can begin to wear;however, because the humeral bearing 106 can remain substantiallystationary, the ulnar head 132 can articulate across the articulationsurface 182 and the wear can be spread across a greater area, includingthe contact area C8.

As described above, the first 108 and second 110 ulnar bearings arepress fit onto the pin 116. Thus the ulnar bearings 108 and 110 aresubstantially stationary within the elbow prosthesis 100. As the ulnarhead 132 articulates, an inner surface of the ulnar head 132 can contactan outer surface of the first ulnar bearing 108 in an area representedby C9 in FIG. 13B. As similarly described above in reference to thearticulation surface 182 of the humeral bearing 106, wear across thefirst ulnar bearing 108 can be spread over a greater area, including thecontact area C9.

The first ulnar bearing 108 can be configured such that the opening 214in the ulnar bearing 108 is offset from an axis of the bearing extension208 (FIG. 8B) of the ulnar bearing 108. Similarly, FIG. 13B shows abearing axis A1 and a pin axis A2, which can be offset from one anotherby a distance D3. A lower region 111 of the first ulnar bearing 108 canoccupy less space between the bearing extension 208 and the opening 214,as compared to an upper region 109 of the first ulnar bearing 108—thisis represented in FIG. 13B by a distance D1 on the upper region 109being greater than a distance D2 on the lower region 111. This offsetcan maximize a material thickness between the bearing extension 208 andthe opening 214 in a region of the prosthesis that can endure common andhigh loads during a life of the prosthesis 100. Moreover, the anatomicload or compressive joint load V3 can be shared by a simultaneouscontact represented by the contact area C8 between the ulnar head 132and the humeral bearing 108 and the contact area C9 between the ulnarhead 132 and the ulnar bearing 108, thus extending the life of theprosthesis 100 by helping to further reduce bearing wear.

The elbow prosthesis 100 can be configured to include multiplecomponents and features that alone or in combination contribute to astability of the elbow prosthesis over a life of the prosthesis insidethe body of the patient. The various bearings can work in combinationwith the fasteners and the pin to provide a stable attachment of theulnar component to the humeral component. The configuration of thebearings can limit or resist micro-motion of the bearings within theelbow prosthesis 100. The bearings can work in combination with thefasteners and the pin of the elbow prosthesis to limit or resistloosening of the fasteners. Multiple points of contact of the fastenerand the pin, with one another and with other parts of the elbowprosthesis, can result in a stable design. The configuration of thebearings being substantially fixed or stationary relative to thearticulating ulnar head of the ulnar component can minimize wear of thebearing articulation surfaces.

FIG. 14 illustrates a method 300 of repairing an elbow joint of apatient using a prosthesis, such as an elbow prosthesis as describedherein. The elbow prosthesis can include an ulnar component and ahumeral component. At 302, a user can insert an ulnar stem of the ulnarcomponent into an ulnar medullary canal of the patient. An ulnar headconnected to the ulnar stem can remain exposed outside of the ulnarmedullary canal. At 304, the user can assemble a bearing assembly ontothe ulnar head. The bearing assembly can include a first ulnar bearing,a second ulnar bearing, and a pin extendable through the first ulnarbearing, the second ulnar bearing, and the ulnar head. At 306, the usercan insert a humeral stem of the humeral component into a humeralmedullary canal. A yoke connected to the humeral stem can remain exposedoutside of the humeral medullary canal. The yoke can include first andsecond ears extending from a base of the yoke.

At 308, a user can connect the ulnar component to the humeral component.In an example, 308 can include placing a first end portion of the pin ofthe bearing assembly into an opening in the first ear of the yoke, andplacing a second end portion of the pin into an opening in the secondear of the yoke. Connecting the ulnar and humeral components can enablethe ulnar component to pivot relative to the humeral component. At 310,a user can secure the ulnar component to the humeral component. In anexample, 310 can include threading a first fastener into the first earof the yoke and a second fastener into the second ear of the yoke. Aportion of the first fastener can engage with the first end portion ofthe pin and a portion of the second fastener can engage with a secondend portion of the pin.

In an example, 310 can include securing the first ulnar bearing to thefirst ear of the yoke and securing the second ulnar bearing to thesecond ear of the yoke. The first ulnar bearing can include a tabinsertable into a recess in the first ear of the yoke. The second ulnarbearing can include a tab insertable into a recess in the second ear ofthe yoke.

In an example, the method 300 can include securing a humeral bearinginto the base of the yoke, prior to connecting the ulnar component tothe humeral component. The humeral bearing can include an articulatingsurface structured to allow articulation of the ulnar head relative tothe humeral component.

In certain examples, at least some of the steps of the method 300 can beperformed in a different order than what is described above. In certainexamples, one or more tools can be used at various steps in the method300 to assist with an assembly of the elbow prosthesis and/or animplantation of the elbow prosthesis into the body of the patient. In anexample, an assembly tool can be used to assemble the bearing assemblyonto the ulnar head of the ulnar component. Reference is made to aco-pending application, U.S. Ser. No. 13/800,650, entitled “ASSEMBLYTOOL FOR A PROSTHESIS,” and directed to an assembly tool configured toassembly the bearing assembly onto the ulnar component. In an example, atool can be used to secure the humeral bearing into the base of theyoke.

Although specific configurations of an elbow prosthesis are shown in thefigures and particularly described above, other designs of an elbowprosthesis can be used. For example, the elbow prosthesis can also becustomized for a patient (e.g., provided with at least one patientspecific component).

The elbow prosthesis 100 can be provided in combination with an assemblytool such that, for example, a user can have easy access to the assemblytool during an implantation procedure for the elbow prosthesis 100. Inan example, a system and/or a kit for repairing an elbow joint of apatient can include the elbow prosthesis 100 and an assembly tool. In anexample, the kit can include a plurality of prostheses of varying sizesand/or a plurality of components of varying sizes. The kit can includeinstructions for use of the assembly tool. In an example, the elbowprosthesis 100 and the assembly tool can be separately provided to theuser, but used in combination during the implant procedure. The assemblytool can be reusable in a subsequent implantation procedure afterundergoing sterilization.

The above detailed description includes references to the accompanyingdrawings, which form a part of the detailed description. The drawingsshow, by way of illustration, specific embodiments in which theinvention can be practiced. These embodiments are also referred toherein as “examples.” Such examples can include elements in addition tothose shown or described. However, the present inventors alsocontemplate examples in which only those elements shown or described areprovided. Moreover, the present inventors also contemplate examplesusing any combination or permutation of those elements shown ordescribed (or one or more aspects thereof), either with respect to aparticular example (or one or more aspects thereof), or with respect toother examples (or one or more aspects thereof) shown or describedherein.

In the event of inconsistent usages between this document and anydocuments so incorporated by reference, the usage in this documentcontrols. In this document, the terms “a” or “an” are used, as is commonin patent documents, to include one or more than one, independent of anyother instances or usages of “at least one” or “one or more.” In thisdocument, the term “or” is used to refer to a nonexclusive or, such that“A or B” includes “A but not B,” “B but not A,” and “A and B,” unlessotherwise indicated. In this document, the terms “including” and “inwhich” are used as the plain-English equivalents of the respective terms“comprising” and “wherein.” Also, in the following claims, the terms“including” and “comprising” are open-ended, that is, a system, device,article, composition, formulation, or process that includes elements inaddition to those listed after such a term in a claim are still deemedto fall within the scope of that claim. Moreover, in the followingclaims, the terms “first,” “second,” and “third,” etc. are used merelyas labels, and are not intended to impose numerical requirements ontheir objects.

The above description is intended to be illustrative, and notrestrictive. For example, the above-described examples (or one or moreaspects thereof) may be used in combination with each other. Otherembodiments can be used, such as by one of ordinary skill in the artupon reviewing the above description. The Abstract is provided to complywith 37 C.F.R. § 1.72(b), to allow the reader to quickly ascertain thenature of the technical disclosure. It is submitted with theunderstanding that it will not be used to interpret or limit the scopeor meaning of the claims. Also, in the above Detailed Description,various features may be grouped together to streamline the disclosure.This should not be interpreted as intending that an unclaimed disclosedfeature is essential to any claim. Rather, inventive subject matter maylie in less than all features of a particular disclosed embodiment.Thus, the following claims are hereby incorporated into the DetailedDescription as examples or embodiments, with each claim standing on itsown as a separate embodiment, and it is contemplated that suchembodiments can be combined with each other in various combinations orpermutations. The scope of the invention should be determined withreference to the appended claims, along with the full scope ofequivalents to which such claims are entitled.

The claimed invention is:
 1. An elbow prosthesis comprising: a humeralcomponent comprising a yoke having first and second ears extending froma base of the yoke; an ulnar component comprising an ulnar head; a pinextending through the ulnar head and connected to the first and secondears to enable the ulnar head to pivot about the pin to facilitatemovement of the ulnar component relative to the humeral component; anulnar bearing assembly connected to the ulnar component and having oneor more features for a press fit engagement of the ulnar bearingassembly with the yoke of the humeral component, the ulnar bearingassembly comprising a first ulnar bearing positioned between the firstear of the yoke and the ulnar head, and a second ulnar bearingpositioned between the second ear of the yoke and the ulnar head; and ahumeral bearing assembly having one or more features for a press fitengagement of the humeral bearing assembly with the yoke of the humeralcomponent, wherein the first and second ulnar bearings are separate fromeach other, and each ulnar bearing is separate from the humeral bearingassembly, wherein each of the first and second ulnar bearings comprisesan internal face, an external face, and an extension portiontherebetween, the external face of the first ulnar bearing configured tocontact the first ear of the yoke and the external face of the secondulnar bearing configured to contact the second ear of the yoke, andwherein the one or more features of the ulnar bearing assembly comprisesa first projection extending from the external face of the first ulnarbearing and a second projection extending from an external face of thesecond ulnar bearing, the first and second projections configured for apress fit with the respective ear of the yoke.
 2. The elbow prosthesisof claim 1 wherein a first end portion of the pin is positioned in afirst opening in the first ear of the yoke and a second end portion ofthe pin is positioned in a second opening in the second ear of the yoke.3. The elbow prosthesis of claim 1 wherein the first projection isconfigured to press fit into a recess in the first ear of the yoke; andthe second projection is configured to press fit into a recess in thesecond ear of the yoke.
 4. The elbow prosthesis of claim 1 wherein theextension portion of each of the first and second ulnar bearings isconfigured to extend into an aperture in the ulnar head such that theinternal face of the first ulnar bearing is positionable adjacent to theinternal face of the second ulnar bearing.
 5. The elbow prosthesis ofclaim 4 wherein the internal face of the first ulnar bearing includes afirst compression rib and the internal face of the second ulnar bearingincludes a second compression rib.
 6. The elbow prosthesis of claim 1wherein the one or more features of the humeral bearing assemblyincludes a peg extending from a bottom surface of the humeral bearingassembly, the peg configured for press fit engagement with a recess inthe base of the yoke.
 7. The elbow prosthesis of claim 1 wherein thehumeral bearing assembly is configured such that the ulnar headarticulates against an articulation surface of the humeral bearingassembly when the ulnar component moves relative to the humeralcomponent.
 8. The elbow prosthesis of claim 7 wherein the humeralbearing assembly includes a first rail located adjacent to thearticulation surface and a second rail located adjacent to thearticulation surface opposite to the first rail, and wherein the one ormore features of the humeral bearing assembly includes a pair of earsformed in corners of each of the first and second rails, the pairs ofears configured for a press fit into the base of the yoke.
 9. An elbowprosthesis comprising: a humeral component comprising a yoke havingfirst and second ears extending from a base of the yoke; a humeralbearing comprising a press-fit feature for securing the humeral bearingin the base of the yoke; an ulnar component comprising an ulnar head; afirst ulnar bearing positionable between the first ear of the yoke andthe ulnar head and comprising a press-fit feature for securing the firstulnar bearing to the first ear, the press-fit feature comprising a firsttab extending from a first external face of the first ulnar bearing, thefirst tab configured to press fit into a recess in the first ear of theyoke; a second ulnar bearing positionable between the second ear of theyoke and the ulnar head and comprising a press-fit feature for securingthe second ulnar bearing to the second ear, the press-fit featurecomprising a second tab extending from a second external face of thesecond ulnar bearing, the second tab configured to press fit into arecess in the second ear of the yoke; and a pin having a first endportion and a second end portion and configured to extend through theulnar head, the first ulnar bearing and the second ulnar bearing,wherein the first end portion of the pin is securable to the first earof the yoke and the second end portion of the pin is securable to thesecond ear of the yoke, wherein the ulnar component is configured topivot about the pin to enable movement of the ulnar component relativeto the humeral component, and wherein the first and second ulnarbearings are separate from each other, and each ulnar bearing isseparate from the humeral bearing.
 10. The elbow prosthesis of claim 9wherein the press-fit feature of the humeral bearing comprises a pegextending from a bottom surface of the humeral bearing, the pegconfigured to press fit into a recess in the base of the yoke.
 11. Theelbow prosthesis of claim 9 wherein the ulnar head is configured toarticulate against an articulation surface of the humeral bearing whenthe ulnar component pivots relative to the humeral component.
 12. Theelbow prosthesis of claim 9 wherein the press-fit feature of the humeralbearing comprises one or more ears extending from a top surface of thehumeral bearing, the one or more ears configured to press fit into thebase of the yoke.
 13. The elbow prosthesis of claim 9 wherein the firstulnar bearing comprises a first extension portion opposite the firstexternal face and configured to extend into an aperture in the ulnarhead, and the second ulnar bearing comprises a second extension portionopposite the second external face and configured to extend into theulnar head, and wherein an inner face of the first extension portion ispositionable adjacent to an inner face of the second extension portion.14. The elbow prosthesis of claim 13 wherein the inner face of the firstextension portion includes a first compression rib and the inner face ofthe second extension portion includes a second compression rib, each ofthe first and second compression ribs configured to compress against theinner face of the other ulnar bearing.
 15. The elbow prosthesis of claim9 further comprising: a first fastener insertable in a first opening inthe first ear of the yoke, the first fastener configured for engagingwith the first end portion of the pin; and a second fastener insertablein a second opening in the second ear of the yoke, the second fastenerconfigured for engaging with the second end portion of the pin.
 16. Theelbow prosthesis of claim 15 wherein the first ear of the yoke comprisesa third opening and the second ear of the yoke comprises a fourthopening, and wherein the third and fourth openings are generallyV-shaped and form first and second seats, and each of the first andsecond end portions of the pin have at least two points of contact withthe first and second seats, respectively.
 17. The elbow prosthesis ofclaim 16 wherein the first fastener is configured to apply a load to thepin to secure the pin within the first seat and the second fastener isconfigured to apply a load to the pin to secure the pin within thesecond seat.